Refining Expert Recommendations for Implementing Change (ERIC) strategy surveys using cognitive interviews with frontline providers

Yakovchenko, Vera; Chinman, Matthew J.; Lamorte, Carolyn; Powell, Byron J.; Waltz, Thomas J.; Merante, Monica; Gibson, Sandra; Neely, Brittney; Morgan, Timothy R.; Rogal, Shari S.

doi:10.1186/s43058-023-00409-3

Cited by 38Health Policy Implementation ScienceDelphi Technique in ResearchHealth Education and Validation

Refining Expert Recommendations for Implementing Change (ERIC) strategy surveys using cognitive interviews with frontline providers

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Yakovchenko, Vera, Chinman, Matthew J., Lamorte, Carolyn, Powell, Byron J., Waltz, Thomas J., Merante, Monica, Gibson, Sandra, Neely, Brittney +2 more·2023·Implementation Science Communications

DOI 10.1186/s43058-023-00409-3PMC PMC10122282

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Abstract

Background: The Expert Recommendations for Implementing Change (ERIC) compilation includes 73 defined implementation strategies clustered into nine content areas. This taxonomy has been used to track implementation strategies over time using surveys. This study aimed to improve the ERIC survey using cognitive interviews with non-implementation scientist clinicians. Methods: Starting in 2015, we developed and fielded annual ERIC surveys to evaluate liver care in the Veterans Health Administration (VA). We invited providers who had completed at least three surveys to participate in cognitive interviews (October 2020 to October 2021). Before the interviews, participants reviewed the complete 73-item ERIC survey and marked which strategies were unclear due to wording, conceptual confusion, or overlap with other strategies. They then engaged in semi-structured cognitive interviews to describe the experience of completing the survey and elaborate on which strategies required further clarification. Results: Twelve VA providers completed surveys followed by cognitive interviews. The “Engage Consumer” and “Support Clinicians” clusters were rated most highly in terms of conceptual and wording clarity. In contrast, the “Financial” cluster had the most wording and conceptual confusion. The “Adapt and Tailor to Context” cluster strategies were considered to have the most redundancy. Providers outlined ways in which the strategies could be clearer in terms of wording (32%), conceptual clarity (51%), and clarifying the distinction between strategies (51%). Conclusions: Cognitive interviews with ERIC survey participants allowed us to identify and address issues with strategy wording, combine conceptually indistinct strategies, and disaggregate multi-barreled strategies. Improvements made to the ERIC survey based on these findings will ultimately assist VA and other institutions in designing, evaluating, and replicating quality improvement efforts.

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Implementation strategies were classified using standard definitions based on minor modifications to the ERIC taxonomy, resulting in 70 named strategies.
“Implementation strategies were classified using standard definitions (MJC, SSR, DEG), based on minor modifications to the ERIC taxonomy [2–4]. Modifications resulted in 70 named strategies and were made to decrease redundancy and improve clarity.”
From A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022 (2024) · cites this paper as [37]

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Additional file 8 of A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022
Ashcraft, L. E., Goodrich, D. E., Hero, J. O., Phares, A. D., Bachrach, R. L., Quinn, D. A., Qureshi, N., Ernecoff, N. C., Lederer, L. G., Scheunemann, L. P., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26738325
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Additional file 6 of A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022
Ashcraft, L. E., Goodrich, D. E., Hero, J. O., Phares, A. D., Bachrach, R. L., Quinn, D. A., Qureshi, N., Ernecoff, N. C., Lederer, L. G., Scheunemann, L. P., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26738319
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Additional file 4 of A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022
Ashcraft, L. E., Goodrich, D. E., Hero, J. O., Phares, A. D., Bachrach, R. L., Quinn, D. A., Qureshi, N., Ernecoff, N. C., Lederer, L. G., Scheunemann, L. P., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26738313
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Additional file 1 of A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022
Ashcraft, L. E., Goodrich, D. E., Hero, J. O., Phares, A. D., Bachrach, R. L., Quinn, D. A., Qureshi, N., Ernecoff, N. C., Lederer, L. G., Scheunemann, L. P., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26738304
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Additional file 7 of A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022
Ashcraft, L. E., Goodrich, D. E., Hero, J. O., Phares, A. D., Bachrach, R. L., Quinn, D. A., Qureshi, N., Ernecoff, N. C., Lederer, L. G., Scheunemann, L. P., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26738322
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Additional file 3 of A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022
Ashcraft, L. E., Goodrich, D. E., Hero, J. O., Phares, A. D., Bachrach, R. L., Quinn, D. A., Qureshi, N., Ernecoff, N. C., Lederer, L. G., Scheunemann, L. P., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26738310
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Additional file 5 of A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022
Ashcraft, L. E., Goodrich, D. E., Hero, J. O., Phares, A. D., Bachrach, R. L., Quinn, D. A., Qureshi, N., Ernecoff, N. C., Lederer, L. G., Scheunemann, L. P., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26738316
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Additional file 2 of A systematic review of experimentally tested implementation strategies across health and human service settings: evidence from 2010-2022
Ashcraft, L. E., Goodrich, D. E., Hero, J. O., Phares, A. D., Bachrach, R. L., Quinn, D. A., Qureshi, N., Ernecoff, N. C., Lederer, L. G., Scheunemann, L. P., et al. (2024) · Figshare · doi:10.6084/m9.figshare.26738307
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Bernués-Caudillo, L., Drury, A., González‐María, E., & Moreno-Casbas, M. T. (2026) · Implementation Science Communications · doi:10.1186/s43058-026-01076-w

Additional file 1 of Refining Expert Recommendations for Implementing Change (ERIC) strategy surveys using cognitive interviews with frontline providers
Yakovchenko, V., Chinman, M. J., Lamorte, C., Powell, B. J., Waltz, T. J., Merante, M., Gibson, S. P., Neely, B., Morgan, T. R., & Rogal, S. S. (2023) · Figshare · doi:10.6084/m9.figshare.22678335
Self-citation
A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project
Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M., Proctor, E. K., & Kirchner, J. E. (2015) · Implementation Science · doi:10.1186/s13012-015-0209-1 · Cited by 4,963 · see citing works
Self-citation
Comparing the CFIR-ERIC matching tool recommendations to real-world strategy effectiveness data: a mixed-methods study in the Veterans Health Administration
Yakovchenko, V., Lamorte, C., Chinman, M., Goodrich, D. E., Gibson, S. P., Park, A., Bajaj, J. S., McCurdy, H. M., Morgan, T. R. M., & Rogal, S. S. (2023) · Implementation Science · doi:10.1186/s13012-023-01307-x · Cited by 35 · see citing works
Self-citation
Specifying and comparing implementation strategies across seven large implementation interventions: a practical application of theory
Perry, C. K., Damschroder, L. J., Hemler, J. R., Woodson, T. T., Ono, S. S., & Cohen, D. J. (2019) · Implementation Science · doi:10.1186/s13012-019-0876-4 · Cited by 288 · see citing works
Use of concept mapping to characterize relationships among implementation strategies and assess their feasibility and importance: results from the Expert Recommendations for Implementing Change (ERIC) study
Waltz, T. J., Powell, B. J., Matthieu, M. M., Damschroder, L. J., Chinman, M. J., Smith, J. L., Proctor, E. K., & Kirchner, J. E. (2015) · Implementation Science · doi:10.1186/s13012-015-0295-0 · Cited by 1,108 · see citing works
Self-citation

Authors: Yakovchenko, V., Chinman, M. J., Lamorte, C., Powell, B. J., Waltz, T. J., Merante, M., Gibson, S., Neely, B., Morgan, T. R., & Rogal, S. S.
Affiliations: VA Pittsburgh Healthcare System (US)
RAND Corporation (US)
Washington University in St. Louis (US)
Eastern Michigan University (US)
University of Pittsburgh (US)
University of California, Irvine (US)
Corresponding author: Rogal, Shari S.
ORCID: Yakovchenko, Vera
Chinman, Matthew J.
Powell, Byron J.
Waltz, Thomas J.
Gibson, Sandra
Morgan, Timothy R.
Rogal, Shari S.
Venue: Implementation Science Communications
Publisher: Springer Science and Business Media LLC
Published: 2023-04-21
Volume: 4
Issue: 1
Pages: 42-42
ISSN: 2662-2211 (ISSN-L)
DOI: 10.1186/s43058-023-00409-3
PMC: PMC10122282
OpenAlex: W4366774448
Cited by: 38
References: 30
Citations by year: 2026: 11 · 2025: 9 · 2024: 17 · 2023: 1
FWCI: 13.46
Type: journal article
Language: en
Open access: gold
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: Implementation Science Communications (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion, cc-by)
Digital Commons@Becker (Washington University School of Medicine) (submittedVersion, cc-by)
DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders: Quality Enhancement Research Initiative (PEC 19-307)
National Institute on Drug Abuse (K23DA048182)
Topics: Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Social Sciences › Sociology and Political Science › Delphi Technique in Research
Social Sciences › Education › Health Education and Validation
Keywords: Expert Recommendations for Implementing Change, implementation strategies, questionnaire development, cognitive interviewing, frontline health workers, Veterans Health Administration, quality improvement

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Refining Expert Recommendations for Implementing Change (ERIC) strategy surveys using cognitive interviews with frontline providers

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